There’s a need for further clinical research to prove the usefulness of cannabis in the treatment of traumatic brain injury.
Traumatic brain injury (TBI) is a leading cause of disability in the US. Statistics from CDC 2014 indicate that an average of 155 people in the United States died each day from injuries that include a TBI. Up to date there is no definitive treatment for traumatic brain injury and most interventions only aim at improving the quality of life of the affected patients. Here is a brief history of TBI.
What is TBI?
Traumatic brain injury occurs as a result of a person sustaining injury to the head either from being struck by an object or the brain being violently jolted. It can be classified as mild, moderate or severe. Most people sustain TBIs from road and sports accidents as well as military-related accidents. About 13,000 servicemen are diagnosed with TBI each year. These are statistics from the Defence and Veterans Injury Centre. TBI symptoms include: loss of consciousness, disorientation, headaches, memory lapses, short attention span, nausea and vomiting, ringing in the years and incoherent speech. Severity of symptoms may vary from one person to the next.
Assessment typically involves an assessment of the patient’s level of consciousness and other neurological assessment. Conventional treatment for TBI includes: rest, use of pain relievers, diuretics, anti-seizure drugs, coma- inducing drugs, surgery in severe cases and rehabilitation.
A Little about Cannabinoids
Cannabinoids are produced by the body and they interact with cannabinoid receptors to support homeostasis in the body. Plants produce phytocannabinoids that act in a similar way to the body’s cannabinoids. The two main phytocannabinoids found in the cannabis plant are tetrahydrocannabinol (THC) and cannabidiol (CBD). It is believed that both THC and CBD play a neuroprotective role that may help in the treatment of TBI.
The Hebrew University of Jerusalem Study
A team from the Hebrew University of Jerusalem led by Prof. Esther Shohami conducted lab research on mice and rats to investigate the relationship between cannabinoids and traumatic brain injury. The cats and mice in the study each received one dose of cannabis and showed significant improvement in the symptoms of TBI that lasted up to three months. This study was published in the Journal of Neurotrauma, june 2019 (https://www.ncbi.nlm.nih.gov/pubmed/30489198).
2-AG is a cannabinoid produced by the body and it plays a role in protecting the brain, however, it is produced in low amounts. The researchers in this study found that 2-AG levels, which is an anti-inflammatory agent, is significantly higher following trauma. They administered plant derived 2-AG to mice and rats in a single dose and they showed positive results for the next three months. According to Shohami, “The brain creates protection; we wanted to mimic what the brain does, and we wanted to do it better.”
A team from the Hebrew University of Jerusalem led by Prof. Esther Shohami conducted lab research on mice and rats to investigate the relationship between cannabinoids and traumatic brain injury. The cats and mice in the study each received one dose of cannabis and showed significant improvement in the symptoms of TBI that lasted up to three months. This study was published in the Journal of Neurotrauma, june 2019 (https://www.ncbi.nlm.nih.gov/pubmed/30489198).
Positive results included improvement in motor and cognitive function. The mice that were untreated did not show any positive improvements. Both CB1 and CB2 receptors are involved in the response, but the CB2 receptor is not involved in causing psychoactive effects.
Shohami worked on synthetic molecules that selectively interact with the CB2 receptors, meaning that they give the benefits offered by cannabinoids without altering the state of consciousness. They studied the effects of cannabinoids on the corticospinal tract; this is the first study that has looked into this relationship.
This discovery may pave for clinical trials to prove if this can offer hope to the millions of people suffering from traumatic brain injury all over the world. Prof. Robert Mechoulam, a renowned cannabis researcher, was part of this milestone study conducted by the Hebrew University of Jerusalem.
Shohami stated how complex the treatment for TBI can be in terms of mechanism and timing. This in turn has caused the failure of many clinical trials. In an ideal situation, the treatment should be administered within a few hours after traumatic brain injury.
Results from this study will be presented at the Cann10 International Medical Cannabis Conference under the title “The role of CB2 receptors in the recovery of mice after traumatic brain injury.”
Another study conducted by the Virginia Commonwealth University showed that cannabinoids could hold a lot of promise in the treatment of traumatic brain injury. This study showed that synthetic 2-AG plays a role in the inflammatory pathways and this could have an impact in: memory and learning, neurological and motor function and the control of seizures.
Yet another study conducted by Ethan Russo, renowned cannabis researcher, showed that cannabinoids play a key role in improving neurological function.
Cannabis research has been derailed by years of criminalization and cannabis prohibition. But with more countries globally warming up to medicinal cannabis, we expect to see large clinical studies that will give concrete guidance on the use of cannabinoids in treating traumatic brain injury.
Traumatic brain injury patients continue to suffer without definitive treatment, as some die following severe TBI. The study by the Hebrew University of Jerusalem is only an eye opener as to the potential that cannabis compounds hold in improving the lives of people living with chronic illnesses, among them TBI.
Very interesting,
Thanks.